Current Treatment Options in Neurology

, Volume 14, Issue 6, pp 541–548

Overview of Therapeutic Hypothermia

CEREBROVASCULAR DISORDERS (HP ADAMS JR, SECTION EDITOR)

DOI: 10.1007/s11940-012-0201-x

Cite this article as:
Song, S.S. & Lyden, P.D. Curr Treat Options Neurol (2012) 14: 541. doi:10.1007/s11940-012-0201-x

Opinion statement

Therapeutic hypothermia has proven neuroprotective effects in global cerebral ischemia. Indications for hypothermia induction include cardiac arrest and neonatal asphyxia. The two general methods of induced hypothermia are either surface cooling or endovascular cooling. Hypothermia should be induced as early as possible to achieve maximum neuroprotection and edema blocking effect. Endovascular cooling has the benefit of shorter time to reach target temperature but catheter insertion requires expertise and training, which may be a barrier to widespread availability. The optimum method of cooling is yet to be determined but a multimodal approach is necessary to address three phases of cooling: induction, maintentance, and rewarm. Specifying core practitioners who are well-versed in established guidelines can help integrate the multidisciplinary team that is needed to successfully implement cooling protocols. Reducing shivering to make heat exchange more efficient with tighter temperature control enables quicker time to target temperature and avoids rewarming which can lead to inadvertent increase in intracranial pressure and cerebral edema. Promising applications but yet to be determined is whether hypothermia treatment can improve outcomes in acute ischemic stroke or traumatic brain injury.

Keywords

HypothermiaTherapeutic hypothermiaCardiac arrestCerebral ischemiaSurface coolingEndovascular coolingShiveringNeuroprotectionTreatment

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of NeurologyCedars-Sinai Medical CenterLos AngelesUSA